Prescription drug abuse is a growing concern for several reasons. The practice of obtaining multiple prescriptions and early refills poses a number of health risks for patients who use prescription drugs;because multiple prescriptions or early refills are not closely monitored, it is sometimes up to the primary care physician to properly screen for signs of potential prescription drug abuse and addiction. Clinicians in primary care settings should be equipped with the knowledge to recognize the signs of potential abuse, as well as the steps necessary to address patients who are deemed to be addicted to, or abusing, prescription drugs. The interaction can be difficult, because many patients are either unaware of or evasive about their addiction or abuse. Providing simulation training to help prepare clinicians to better screen patients for potential prescription drug abuse and to identify treatment methods to help these high-risk patients deal with their chronic pain would be very effective. For the Phase II application, SIMmersion LLC, in cooperation with Dr. Michael Fleming of the University of Wisconsin, proposes to develop and evaluate a full-featured interactive simulation to train clinicians in primary care settings how to screen for prescription drug misuse and apply pain management plans. The proposed training simulation will allow physicians and other primary healthcare practitioners to practice the detection and management of prescription opioid misuse in patients suffering from chronic pain. The ideal outcome would be that clinicians become more proficient and comfortable with these skills, and therefore more likely to use them as a routine part of their practice with all patients, thereby reducing the number of people being harmed by the misuse of prescription drugs. To evaluate the efficacy of the simulation training system, Dr. Fleming and his research team will conduct an educational trial. One hundred students and practitioners will be randomly assigned to usual education on prescription drug abuse and misuse (n=50) or to the SIMmersion training program (n=50). Subjects will complete baseline and 6-month post-measures of knowledge and clinical behavior. The measures will include a knowledge pencil-and-paper test and standardized patients. The research will be conducted at the UW Health Sciences Clinical Teaching and Assessment Center. The simulated patient program, using the SIMmersion technology, is expected to significantly advance our ability to train medical professionals in human processing and interaction skills. We expect the end result of the SBIR grant will include improved skills among healthcare professionals in prescription drug screening and application of pain management plans, as well as improved patient outcomes for those who use prescription drugs to manage chronic pain. PUBLIC HEALTH RELEVANCE: Innovative and economical technologies that assist primary care clinicians in acquiring competence in screening patients for prescription drug abuse and chronic pain management could help increase the frequency and efficacy of screening for potential abuse. Screening patients for prescription drug abuse in primary care settings and implementing treatment management plans may help identify abuse sooner and lead to life-changing interventions, which could reduce the negative impact of prescription and other drug abuse and addiction.